In the current study, we investigated the longitudinal association between dietary acid load and the risk of insulin resistance (IR) in the Tehranian adult population. This longitudinal study was conducted on 925 participants, aged 22~80 years old, in the framework of the third (2006~2008) and fourth (2009~2011) phases of the Tehran Lipid and Glucose Study. At baseline, the dietary intake of subjects was assessed using a validated semi-quantitative food frequency questionnaire, and the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated at baseline. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up; IR was defined according to optimal cut-off values. Multiple logistic regression models were used to estimate the risk of IR according to the PRAL and NEAP quartile categories. Mean age and body mass index of the participants were 40.3 years old of $26.4kg/m^2$, respectively. Mean PRAL and NEAP scores were -11.2 and 35.6 mEq/d, respectively. After adjustment for potential confounders, compared to the lowest quartile of PRAL and NEAP, the highest quartile was accompanied with increased risk of IR [odds ratio (OR)=2.81, 95% confidence interval (CI)=1.32~5.97 and OR=2.18, 95% CI=1.03~4.61, respectively]. Our findings suggest that higher acidic dietary acid-base load, defined by higher PRAL and NEAP scores, may be a risk factor for the development of IR and related metabolic disorders.
The aim of this study was to examine the relationship between dietary variables and the prevalence of insulin resistance (IR) in middle-aged Korean adults using data from the 2007-2009 Korea National Health and Nutrition Examination Survey. Because IR is closely linked with metabolic syndrome, subjects were divided into three groups according to symptoms of metabolic syndrome: the 'Normal group' without any symptoms, the 'Risk group' with one or two symptoms, and the Metabolic syndrome (MetS) group' with three or more symptoms. Subjects between the ages of 30 and 65 years with no prior diagnosis or treatment for diabetes, hypertension, or dyslipidemia were selected. The number of subjects per group was as follows: 2,085 adults in the Normal group, 3,699 adults in the Risk group, and 1,160 adults in the MetS group. Metabolic syndrome was defined according to Adult Treatment Panel III criteria with modified waist circumference cutoff values (men ${\geq}$ 90 cm, women ${\geq}$ 85 cm). Subjects with HOMA-IR > 2.0 were classified as IR. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was calculated using the following formula: (fasting plasma glucose ${\times}$ fasting plasma insulin)/22.5. Nutrients and food groups intake were obtained from a single 24-hour recall. Subjects with IR in the Normal group were more obese and less physically active than non-IR subjects. In the MetS group, subjects with IR were more obese and had a lower prevalence of smoking and drinking, compared with non-IR subjects. Men with IR in the Normal group had a tendency to consume more oils and sugars than non-IR men, while women with IR in the same group had higher intake of carbohydrate, dietary glycemic index, and dietary glycemic load than non-IR women. Women with IR in the Risk group had lower energy intake but higher intake of oils and sugars than non-IR women. In the MetS group, consumption of fruits was higher in subjects with IR than in non-IR subjects. In conclusion, findings of this study suggest that dietary carbohydrate intake, including glycemic index, may be associated with IR in healthy women. Further research in prospective cohort studies in order to examine the effects of dietary carbohydrate on IR incidence will be necessary.
The nutritional status and chronic disease occurrence of the elderly living in local areas is affected by certain factors, including low energy intakes, low food diversity, poor nutritional quality and living alone. Moreover, elderly people who live alone may have low incomes and be socially isolated. Thus, we have provided them adjustable and balanced menus using standard recipes. In this study, we investigated aspects of nutritional status and living conditions in the elderly status, in relation to food, activities of daily living(ADL), nutrition risk index, average intake of calories and nutrients, the mini dietary assessment index score, depression score, menu satisfaction, menu demand, satisfaction with menu offerings. The result indicated significant nutritional improvements by providing menus to the elders and suggest that by providing adjustable and balanced menus using standard recipes, the nutritional status of isolated elders can be changed and improved.
Objectives: Studies that reported the association between diet quality/nutritional intake status and mortality have rarely used long-term follow-up data in Asian countries, including Korea. This study investigated the association between the risk of mortality (all-cause and cause-specific) and the diet quality/nutritional intake status using follow-up 12-year mortality data from a nationally representative sample of South Koreans. Methods: 8,941 individuals who participated in 1998 and 2001 Korea Health and Nutrition Examination Surveys were linked to mortality data from death certificates. Of those individuals, 1,083 (12.1%) had died as of December, 2012. Cox proportional hazard models were used to estimate the relative risks of mortality according to the level of diet quality and intakes of major nutrients. Indicators for diet quality index and nutritional intake status were assessed using MAR (mean adequacy ratio) and energy and protein intake level compared with the 2010 Korean DRI. Results: Higher diet quality/nutritional intake status were associated with lower mortality; the mortality risk (95% confidence interval) from all-cause of lowest MAR group vs highest was 1.66 (1.27 to 2.18) among ${\geq}30$ year old, and 1.98 (1.36 to 2.86) among 30~64 year old individuals. Those with below 75% of energy and protein intake of Korean DRI had higher mortality risks of all-cause mortality compared to the reference group. Diet quality/nutritional intake status was inversely associated with mortality from cardiovascular diseases and cancer. Conclusions: Poor Diet quality/nutritional intake status were associated with a higher risk of mortality from all-cause and mortality from cardiovascular diseases and cancer among South Korean adults.
This study was conducted in order to compare weight control behaviors, eating disorder risk, and depression in female adolescents according to dieting experience during the last year. The subjects were 707 students attending a girls' high school in Seoul, and all the information was collected by self-administered questionnaire. Eating disorder risk and depression were determined by using EAT-26 (Eating Attitude Test-26) and PHQ-9 (Patient Health Questionnaire-9), respectively. Data were compared between subjects with experience of dieting (320) and those without (387). More of the subjects with dieting experience were unsatisfied with their own body weights (76.9% vs. 44.2%, P<0.01) and weighed themselves frequently (P<0.01) compared to those without diet experience. EAT-26 ($11.63{\pm}8.3$ vs. $5.99{\pm}4.7$, P<0.01) and PHQ-9 scores ($7.05{\pm}4.6$ vs. $6.00{\pm}4.4$, P<0.01) were higher in subjects with dieting experience compared to their counterparts. Therefore, we concluded that dieting is associated with several undesirable psychological aspects such as eating disorder risk and depression in adolescent girls, and thus providing proper education is urgently needed to emphasizing importance of healthy weight and the danger of unnecessary dieting.
This study was designed to investigate the impact of a 12-week nutrition education program on 32 male industrial workers (average age: $44.5{\pm}3.8$ yrs, work duration period: $20.1{\pm}5.6$ yrs) diagnosed as having dyslipidemia in a medical checkup at their workplace. This program was implemented with a conceptual framework on strengthening self-efficacy for the improvement of the health conditions of the workers. Most of all, the study exhibited benefits in the industrial workers by ameliorating the risk factors associated with dyslipidemia via changes in dietary behaviors, nutritional knowledge, and attitudes, as well as anthropometric and biochemical parameters. After the nutrition education, overall lifestyle, including the ratios of smoking (P<0.05) and drinking (P<0.01), significantly improved. Exactly 65.6% of the subjects reported that their dietary habits changed. Body weight, BMI, percentage of body fat, and waist circumference all significantly decreased (P<0.001). The systolic (P<0.01) as well as diastolic blood pressures (P<0.001) decreased. Moreover, the degree of increase in serum HDL-cholesterol was appreciable (P<0.001), and the atherogenic index also decreased (P<0.01). Further, risk factors related to metabolic syndrome in subjects significantly decreased (P<0.001). The average scores for nutrition knowledge increased from 9.3 to 17.7 points (P<0.001). All of the participants agreed on the need for a nutrition education program at their workplace. Further, it should be pointed out that the participants strongly indicated the need for continuing nutrition intervention.
Objectives: The purpose of the study was to examine the association between diabetes mellitus and community periodontal index in Korean adults. Methods: The study populations were recruited by the Fifth Korea National Health and Nutrition Examination Survey. Study subjects were 10,411 who were examined oral examination, blood test, and aged over 19 years. Using multiple logistic regression analyses, the variables were adjusted for gender, age, household income, family history of diabetes, body mess index, smoking habit, and frequency of tooth brushing. Periodontal tissue examination of the subjects was performed and scored by Community periodontal index(CPI). Using probe, six teeth were examined for hemorrhage, plaque, and pocket depth and classified into $CPI_0$, $CPI_1$, $CPI_2$, $CPI_3$ and $CPI_4$. Healthy periodontal groups($CPI_{0-2}$) and periodontal disease groups($CPI_{3-4}$) were divided by the periodontal disease status. The definition of diabetes mellitus(DM) was decided by the diagnosis by the doctors and fasting blood sugar level. Those who were diagnosed as DM were included in DM group. The DM variables included normal blood sugar level, increased fasting blood sugar level, and DM blood sugar level. The DM variables were compared to periodontal disease blood sugar level and analyzed. Results: The periodontitis prevalence rate was 23.2%. Those who had diabetes mellitus accounted for 5.5% of the subjects. Those who had impaired fasting glucose accounted for 17.7% and 7.9% of subjects were diabetes mellitus by blood test. In the confirmed diabetes group by doctor, the periodontitis prevalence rate was significantly higher than the non-diabetic group. Diabetic group by blood test had the highest prevalence rate of periodontitis than those who had impaired fasting glucose group or normal group. After adjusting for gender, age, household income, family history of diabetes, body mass index, smoking habit, and frequency of tooth brushing, the risk of periodontitis in diagnosed diabetes mellitus was 1.57 times(95% CI; 1.27-1.94) higher than the normal group. In impaired fasting glucose group and diabetes mellitus group by blood test, the risk of periodontitis was 1.11 times(95% CI; 0.95-1.30) and 1.45 times(95% CI; 1.45-2.12) higher, respectively. Conclusions: There was a significant relationship between diabetes mellitus and periodontitis in Korean adults. These results suggest that diabetes mellitus is a risk factor for periodontitis.
The purpose of this research was to study food behaviors and nutrient intakes according to body mass index(BMI) and body image recognition in 211 female university students in Incheon. The majority of the surveyed subjects were in the normal range for BMI. Most of these female university students preferred a thin body type and were not satisfied with their body shapes. Most also controlled their body weight for appearance by exercising and limiting food intake. The obese group often ate processed foods(p<0.01) and ate out(p<0.05). The underweight group and normal-weight group took vitamins and supplements more frequently(p<0.001). Those students who recognized their body image as a 'fat shape' had good appetites(p<0.05) and those who recognized themselves as 'normal shape' considered food formulations ate every meal (p<0.05) and consumed vitamins and other supplements frequently(p<0.01). The mean calorie intake of all students was about 80% of the recommend amount, so there was a risk of lack of various nutrients. The 'fat' students by body image recognition had lower calorie intakes in order to reduce body weight. In all the groups, there was a lack of vitamins $B_1$ and $B_2$, as well as the minerals Ca and Fe. Therefore, education on correct body image recognition and training on proper weight control are deemed necessary. In addition, education and counseling on nutrition that are tailored to individual status are needed.
In recent years, the number and proportion of Korean elderly have grown rapidly, and elderly individuals show a disproportionate risk for poor nutritional status. The purpose of this study was to examine the relationship of sociodemographic background to nutrient intake of persons 65 years of age or older, living in 15 cities in Korea. Data on 1973 subjects (603 males, 1370 females), who participated in the Korean Elderly Nutrition Survey (2000), were analyzed. Their mean age was 72.3 years and their mean body mass index (BMI) was 24.2 kg/$m^2$. Basic sociodemographic data were obtained through personal interviews. The 98-item semi-food frequency questionnaire, developed and previously validated for Korean middle-aged and elderly subjects, was administered. “Percentage of subjects who consumed under 75% Korean RDA,” “number of nutrients consumed below 75% Korean RDA,” “mean nutrient adequacy ratio,” and “nutrient density” were used to determine nutritional status. Male elderly had better nutritional quality than female elderly. Nutritional quality decreased with age, especially in older elderly (over 75). Elderly who were underweight (BMI 〈 20 kg/$m^2$) showed poorer nutritional quality than those who were normal weight (BMI 20∼25 kg/$m^2$) and overweight (BMI $\geq$ 25 kg/$m^2$). Elderly who lived alone had significantly poorer nutritional quality than those who lived with a spouse, and/or with children. Lower education level and economic dependence also showed lower nutritional quality. A stepwise multiple regression analysis was performed to examine the effects of specific sociodemographic factors on nutritional quality. For number of nutrients under 75% RDA as a dependent variable, education level explained 4.8% of the variance, followed by living status, age, body mass index, gender, and living expense support (Model $R^2$ = 0.091). For mean nutrient adequacy ratio as a dependent variable, model $R^2$ was 0.098. Therefore, sociodemographic variables such as gender, age, body mass index, living status, educational level, and economic status influenced elderly nutrition status. These results indicate that an elderly nutrition intervention should focus on subjects who are poorly educated, living alone, age 75 or older, and/or underweight.
Higher bone mineral density (BMD) at a young age, calcium intake, and exercise are important for prevention of osteoporosis later in life. We examined familial effects of BMD between mothers and children and adolescents aged 8-19 in Cheonan, Korea and the relationships between BMD and lifestyle parameters, including: food and nutrient intake and exercise. For daughters and sons, significant differences in BMD were observed at the three bone sites (total femur, femur neck, and lumbar spine) according to age, gender, body mass index, exercise, and milk consumption, compared to the reference value for each classification category. Mean differences in children's BMD were observed according to maternal BMD. Energy and calcium intake were lower in both children and mothers in comparison to the estimated daily energy requirement; however, their protein intake was much greater than the daily recommended intake. After adjusting for age and gender and for mother's age, body mass index, and total calorie intake, results of the food frequency test showed an association of a higher intake of meat, meat products, milk and milk products with greater BMD of total femur, femur neck, and lumbar spine of children. In addition, exercise was positively associated with higher BMD. Regression analysis showed a positive association of BMD with age, male gender, exercise, and mother's BMD. In conclusion, after adjustment for environmental parameters, maternal BMD had a positive influence on BMD in daughters and sons. This finding suggests that parents need to check their BMD in order to determine whether their children are at increased risk of low BMD.
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